REQUEST FOR TERMINATION or MODIFICATION OF CHILD SUPPORT WITHHOLDING FC 158.402 & FC 158.403
NOTICE: REQUEST MUST BE NOTARIZED AND DELIVERED TO THE DISTRICT CLERK WITH A FEE OF $15.00 TO ACTIVATE THE TERMINATION OF WITHHOLDING.
CAUSE NO. ______________ STYLE:____________________________________________ ____________________________________________ ____________________________________________ OBLIGOR: NAME:____________________________________________________________ ADDRESS:_________________________________________________________ PHONE:________________________ SOC. SEC.#_________________________
OBLIGEE:
NAME:____________________________________________________________ ADDRESS:_________________________________________________________ PHONE:________________________ SOC.SEC #_________________________
THE OBLIGEE AND OBLIGOR NAMED HEREIN HEREBY AGREE THAT THE EMPLOYER SHALL IMMEDIATELY TERMINATE THE WITHHOLDING OF CHILD SUPPORT.
_________________________________ OBLIGEE SUBSCRIBED TO AND SWORN TO BEFORE ME THIS DAY OF , 20 .
________________________________________ MY COMMISSION EXPIRES OF TEXAS ________________________________________
Notary Public In And For The STATE
PRINTED NAME OF NOTARY _____________________________________________ OBLIGOR SUBSCRIBED TO AND SWORN TO BEFORE ME THIS DAY OF , 20 .
_______________________________________
MY COMMISSION EXPIRES OF TEXAS ________________________________________
Notary Public In And For The STATE
PRINTED NAME OF NOTARY